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This book is impressive from the very first perusal. Partly because of the sheer size of the work—nearly five hundred pages—and partly because of the range of views of 'borderline' phenomena incorporated in its table of contents, one is a little awed to begin with. Later, upon reading it carefully, that initial view changes to a solid appreciation based on a great deal of data.
The first section contains an extensive review of the psychiatric and psychoanalytic literature that contributed to the present usage of the term 'borderline'. Meissner discusses first the evolution from the concept as a transient state to the concept as it has been additionally applied to a more stable (through time) kind of personality organization with the resulting volatile behaviours and symptoms. Here he discusses the work of Knight, Zilboorg, Rangell, D. F. Klein, Zetzel, Grinker, Kernberg, Mack, Gunderson, and others. The other main conceptual dilemma Meissner pursues is how to locate borderline phenomena in relation to psychosis or neurosis. Here he makes the point that borderline conditions have been generally linked to psychosis but not neurosis, and reviews earlier concepts of 'pseudoneurotic schizophrenia', 'latent psychosis', 'ambulatory schizophrenia', and 'psychotic character', extending the review to the work of Geleerd, Frosch, Bychowski, and Modell, among others.
The second part of the literature review turns to theoretical perspectives in the literature relating to borderline pathology and delineates eight perspectives. The first, instinctual defects, comments on the importance of oral aggressive predisposition, especially demonstrating Kernberg's tie to Melanie Klein in that regard, in contrast to Mahler's emphasis on the mother's interaction. The second, defensive impairment, notes Kernberg's emphasis on splitting as the hallmark of borderline pathology, which is seriously questioned, as well as noting the comments of others on defensive denial and the mixture of p